Neck and shoulder pain with previous history of carpal tunnel syndrome

Dear Ask The Doctor: Ive been having neck and shoulder pain for years now. Ive had all kinds of xrays done they have found nothing I hurt my right arm back in 2007 pulling wood. Now my right side neck hurts and arm i has been swelling and feeling little needles in hand at times. I do have carpal tunnel in both wrists I've tried soaking in a hot tub muscle rub tylenol tylenol 3 elevating my arm. Plz help this is all day pain.

Dear Bobbie jo: When any nerve root in the cervical spine is irritated through compression or inflammation, the symptoms can radiate along that nerve’s pathway into the arm and hand. The specific cervical radiculopathy symptoms will depend primarily on which nerve is affected. The symptoms may also be referred to as radicular pain. Any condition that injures or somehow irritates the cervical nerve can cause cervical radiculopathy. The most common causes include: herniated or bulging disc, cervical stenosis (narrowing space for spinal canal), degenerative disc disease. Any of these causes may produce pain, weakness or numbness in the areas served by the damaged nerve. Pain can be in one area only, like the shoulder, or progress along the entire arm. The type of pain also can vary. Some patients describe dull, all over pain; others describe the pain as severe burning or sharp. Patients may feel tingling, “pins and needles,” or numbness. There is a wide range of treatment options available for cervical radiculopathy, and the treatment will depend mainly on the underlying cause as well as the severity of symptoms. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation,  also a re-education of your habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. If the condition fails to improve with a comprehensive rehabilitation program and selective injections then, you should be presented with a surgical evaluation. Often, there is a progressive improvement over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation.